Cognitive-Behavioral Therapy

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KEY POINTS

• Cognitive-behavioral therapy helps you look at your thoughts, beliefs, and actions, and understand which ones cause problems for you. Then you learn to change the unhealthy way of thinking and acting.
• Cognitive-behavior therapy is problem-focused and goal-oriented. It may be used in individual, family, and group therapy settings.

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What is cognitive-behavioral therapy?

Your thoughts, and how you react to things, affect how you feel about yourself and your life. Negative thoughts can lead to depression, anxiety, or behaviors that cause problems with relationships, school, or work. Cognitive-behavioral therapy helps you change how you think and react. CBT helps you:

• Look at your thoughts, beliefs, and actions, and understand which ones cause problems for you. You learn to replace these thoughts and beliefs with healthy ones. This is the cognitive, or thinking, part of CBT.
• Face the challenges in your life calmly, and then take actions that are likely to have good results. This is the behavioral, or action, part of CBT.

Cognitive-behavioral therapy is different from other kinds of therapy in several ways. It is:

• Goal-oriented: It will help you define your goals, plan ways to accomplish those goals, and check your progress.
• Short-term: Depending on your problem and how hard you work to change your thoughts and behaviors, goals can usually be achieved in less than 20 sessions.
• Self-help oriented: CBT focuses on helping you learn ways to manage your life better.
• Active. CB therapists ask questions and actively listen to you. The therapist may give you assignments to be completed between sessions.

When is it used?

CBT can help with:

• Anxiety or phobias
• Anger management
• Depression or grief
• Eating disorders
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Problems with relationships, family, work, and school
• Pain or long-term illness
• Drug and alcohol abuse
• Sleep disorders
• Sexual disorders

CBT can help you feel better without using medicine. It can also be used along with medicine.

What happens during a typical therapy session?

The therapist will ask you what problem you'd like to work on during therapy. You and the therapist will talk about the problem you identified, and your thoughts and beliefs.

In CBT, you become aware of thoughts that are false or hurtful. These thoughts are called "distorted thinking" because they are not based on what is really true. You may have learned to think this way from things that happened when you were young or from recent experiences. The thoughts pop into your mind automatically.

In therapy, you learn to be aware of your distorted thoughts. You learn to replace them with healthy and true thoughts. For example, you may think "Everybody hates me." You feel sad when you think this, and that makes you not feel good about yourself. During CBT, you would learn to change or argue with this thought. You might think to yourself, "Well, I have at least 4 friends, so some people like me." After thinking this new thought, you might feel hopeful and feel better about yourself.

You may also learn to:

• Stop bad habits
• Express your thoughts and feelings openly and say no when someone asks you to do something that you do not want to do
• Improve how you manage stress

How do I find a therapist?

Psychologists, psychiatrists, and social workers may provide CBT. CBT is used in individual, family, and group therapy settings.

Ask questions and get referrals from people you know and trust. You could check with:

• Your healthcare provider
• Your clergyman, school teachers, or school counselors
• Friends or family members who have been in therapy
• Your health insurance company
• Your employee assistance program (EAP) at work
• Local mental health or human service agencies
• Professional associations of psychologists, psychiatrists, or counselors